Online Application Form – Year 10 This application form should be completed by those who are applying for a place at Silverstone UTC in either Year 10 or Year 11. If you are applying for more than one student in the same academic year (e.g. twins), please submit separate applications. Application for entry in:- September 2019September 2020In-Year Transfer Year 10In-Year Transfer Year 11 Personal Details - Parent / Carer Details Title MrMrsMissMsOther Surname Forename Parent / Carer Address Address Line 1 Address Line 2 Town County Postcode Mobile / Daytime Number Home Number Parent Email Relationship to child MotherFatherStep-parentFoster ParentSocial WorkerOther Personal Details - Child Legal Surname Forenames Child's Address This must be the address where the child normally lives and refers to the address that is registered with the child’s doctor. If there will be a change of address before admission, please contact the UTC at the address on the top of this form. Address Line 1 Address Line 2 Town County Postcode Date of Birth (if no calendar is present, use the format yyyy-mm-dd) Gender of Student ---MaleFemaleOther Current School and Town Does your child have an Education, Health and Care (EHC) Plan or a Statutory Statement of Special Educational Needs? YesNo Does your child have a learning difﬁculty, disability, sensory impairment or medical condition? YesNo If yes, please select type, otherwise select "None" NoneSpecific learning difficulty (SPLD)Moderate learning difficulty (MLD)Severe learning difficulty (SLD)Profound & multiple learning difficulty (PMLD)Social, emotional and mental health (SEMH)Speech, language and communication needs (SLCN)Hearing impairment (HI)Visual impairment (VI)Multi-sensory impairment (MSI)Physical disability (PD)Autistic spectrum disorder (ASD)Other difficulty / disorder (OTH)SEN support but no specialist assessment of type of need (NSA) Do you feel that you will need extra support in your studies for any other reason?YesNo If "Yes", please state Is the child in public care of a local authority? If yes, please state which local authority (in the box below). YesNo Was the child previously in public care but immediately after this became subject to an adoption, residence/child arrangements order or special guardianship order? If yes, please also provide a letter from the social worker confirming the legal status of the child and the local authority with whom the child is in care. YesNo Local Authority (if relevant) Is the child subject to a court order or known to another agency? (i.e. CAF, Youth Offending Service, Social Services). YesNo If yes: Name of Agency involved Name and contact number of agency worker involved Is the child a refugee or an asylum seeker? YesNo Has the Educational Inclusion and Partnership Team of your local authority been involved with the family? YesNo Does the child attend school regularly (i.e. >90% attendance)? YesNo How many Fixed Term Exclusions has the child had? Please give details. Has the child ever been permanently excluded? Please give details. Please add any information you would like us to know? Include the reasons for your application and any other relevant information. Does the child have a parent / carer who is employed by Silverstone UTC? It is your responsibility to tell us if you are employed by the UTC as the information here is processed electronically and may not have names associated when applying the admissions over-subscription criteria. YesNo Name of parent / carer employed by Silverstone UTC Does the child have an older sibling already attending the UTC? A sibling is defined as a biological or legally adopted brother or sister residing in the same household. This is taken to include a step-brother/sister, half-brother/sister, or child who is adopted or fostered, in all cases providing they are living at the same address. Cousins, nieces, nephews and unrelated children sharing an address with the applicant are not considered siblings. The older sibling must be continuing at the UTC at the time of admission of the younger sibling. It is your responsibility to inform us if there is a sibling link. If you do not include details of your child’s older brother or sister, we cannot consider your child under the sibling criterion when applying the admissions criteria. YesNo Name and Surname of youngest sibling already attending the UTC Date of Birth of sibling Gender of sibling Is your child a member of a Service (UK Armed Forces) family or Crown Servant Family? YesNo If your application is unsuccessful through over-subscription, please tick here if you would like to be placed on our waiting list Course Application Details All students must choose a Specialism, and then preferences for GCSE study from the options below. We cannot guarantee to be able to offer your first preference of GCSEs but we will endeavour to do so. If insufficient students apply for a particular subject, we may choose not to run that subject. Specialism High Performance EngineeringBusiness & Technical Events Management You must now select any three of the following eight option subjects. These are in addition to the specialism subject, English Language, English Literature and Science subjects (Physics & Chemistry). Failure to select exactly three may mean that we have to decide for you which subjects you will take. Please make sure that you have selected three subjects before submitting this form. Use CTRL+CLICK to select 3 options. Select Options (required) Computer ScienceMedia StudiesGerman*ICTGeographySmart Product Design and ManufactureBTEC SportCitizenship Reserve Subject (required) Computer ScienceMedia StudiesGerman*ICTGeographySmart Product Design and ManufactureBTEC SportCitizenship *Please DO NOT choose German unless you have already studied this subject throughout KS3 Reason for choosing Silverstone UTC (or any other comments) Ethnic Origin WBRI White - BritishWIRI White - IrishWIRT Traveller of Irish heritageWOTH Any other white backgroundWROM Gypsy / RomaMWBC White and Black CaribbeanMWBA White and Black AfricanMWAS White and AsianMOTH Any other mixed backgroundAIND IndianAPKN PakistaniABAN BangladeshiAOTH Any other Asian backgroundBCRB Black CaribbeanBAFR Black - AfricanBOTH Any other Black backgroundCHNE ChineseOOTH Any other ethnic groupREFU Refused – prefer not to say How did you find out about us? My schoolUTC WebsiteMailing from County CouncilMailing from UTCParents/FriendsOpen EventNewspaper AdvertNewspaper ArticleWeb ArticleFacebookTwitterGoogle AdOther Declaration Terms and Conditions I wish to apply for a place Silverstone UTC; I certify that I am the person with parental responsibility for the child named and that the information given is true to the best of my knowledge and belief; I understand that any fraudulent, or deliberately misleading information given on or omitted from this form, and/or in any supporting information, may render this application invalid, and may lead to the offer of a place being withdrawn; I understand that the Admissions Team may need to share the information on this form with other professionals; I understand that the UTC cannot be held responsible if the application is late either because of delays in the postal system, failures of IT systems or because I have not completed the form correctly; I understand that, if I have made more than one application, the UTC will use the latest dated (most recent) application when allocating a school place. Any previous offer of a school place will be removed if a preference can be offered from this subsequent application; I understand that completion of this form does not automatically guarantee me a place at the UTC; I understand that the UTC reserves the right to amend course details if necessary, and that optional subjects may not all be available or granted. Data Protection Statement Information contained in this form is personal data. It will be held in a computer and is subject to the Data Protection Act 1998. The information you provide will be passed to the Education and Skills Funding Agency (ESFA). The ESFA is responsible for funding and planning education and training for children and adults in England, and are registered under the Data Protection Act 1998. The information you provide will be shared with other organisations for the purpose of administration, careers and other guidance and statistical and research purposes. Other organisations with which we will share information include, the Department for Education, Connexions, Higher Education Statistics Agency, Higher Education Funding Council for England, educational institutions and organisations performing research and statistical work on behalf of the ESFA or their partners. The ESFA is also a co-ﬁnancing organisation and uses European Social Funds from the European Union to directly or indirectly part ﬁnance learning activities, helping develop employment by promoting employability, business spirit and equal opportunities, and investing in human resources. At no time will your personal information be passed on to organisations for marketing or sales purposes.” Privacy Notice for pupils/parents Data Protection Act 1998: How we use pupil information We collect and hold personal information relating to our pupils and may also receive information about them from their previous school, local authority and/or the Department for Education (DfE). We use this personal data to: support our pupils’ learning monitor and report on their progress provide appropriate pastoral care; and assess the quality of our services This information will include their contact details, national curriculum assessment results, attendance information, any exclusion information, where they go after they leave us and personal characteristics such as their ethnic group, any special educational needs they may have as well as relevant medical information. For pupils enrolling for post 14 qualifications, the Learning Records Service will give us the unique learner number (ULN) and may also give us details about your learning or qualifications. Once pupils reach the age of 13, the law requires us to pass on certain information to the Local Authority (Northamptonshire County Council) who have responsibilities in relation to the education or training of 13-19 year olds. We may also share certain personal data relating to children aged 16 and over with post-16 education and training providers in order to secure appropriate services for them. A parent/guardian can request that only their child’s name, address and date of birth be passed to Northamptonshire County Council by informing the Principal. This right is transferred to the child once he/she reaches the age 16. For more information about services for young people, please go to our local authority website. We will not give information about our pupils to anyone without your consent unless the law and our policies allow us to do so. If you want to receive a copy of the information about your son/daughter that we hold, please contact the Principal. We are required, by law, to pass some information about our pupils to the Department for Education (DfE). This information will, in turn, then be made available for use by the LA. DfE may also share pupil level personal data that we supply to them, with third parties. This will only take place where legislation allows it to do so and it is in compliance with the Data Protection Act 1998. Decisions on whether DfE releases this personal data to third parties are subject to a robust approval process and are based on a detailed assessment of who is requesting the data, the purpose for which it is required, the level and sensitivity of data requested and the arrangements in place to store and handle the data. To be granted access to pupil level data, requestors must comply with strict terms and conditions covering the confidentiality and handling of data, security arrangements and retention and use of the data. For more information on how this sharing process works, please visit: https://www.gov.uk/guidance/national-pupil-database-apply-for-a-data-extract For information on which third party organisations (and for which project) pupil level data has been provided to, please visit: https://www.gov.uk/government/publications/national-pupil-database-requests-received If you need more information about how our local authority and/or DfE collect and use your information, please visit: our local authority at http://www.northamptonshire.gov.uk/ ; or the DfE website at https://www.gov.uk/data-protection-how-we-collect-and-share-research-data By submitting this form, you confirm that you have read and understood the above statement and agree that, by using these services, you are accepting the terms of this Privacy Notice and consenting to the collection, use, disclosure and retention of your personal data, and the children/young people named on this form, as described in this Privacy Notice. You also confirm that where a linked sibling is named who is 16 or over, that you have the authority to submit this form on their behalf to confirm that he/she also accepts these terms and conditions and consents to the collection, use, disclosure and retention of personal data. BEFORE SUBMITTING THIS FORM please ensure that you have: Read our prospectus to understand the different options available. Check that you have filled out all relevant sections of the form accurately. Check that the county of the child’s home address is accurate.